Current clinical, electrocardiographic, and electrophysiological risk factors are insufficient to accurately predict sudden cardiac death in asymptomatic individuals with Brugada syndrome.
Systematic Review
How should asymptomatic individuals with Brugada syndrome be risk-stratified and managed?
Current risk stratification markers are insufficient to accurately predict sudden cardiac death in asymptomatic individuals with Brugada syndrome, complicating the decision for ICD implantation.
Brugada syndrome (BrS) is a primary electrical disease associated with increased risk of sudden cardiac death due to polymorphic ventricular arrhythmias. The prognosis, risk stratification, and management of asymptomatic individuals remain the most controversial issues in BrS. Furthermore, the decision to manage asymptomatic patients with an implantable cardioverter-defibrillator should be made after weighing the potential individual risk of future arrhythmic events against the risk of complications associated with the implant and follow-up of patients living with such devices, and the accompanying impairment of the quality of life. Several clinical, electrocardiographic, and electrophysiological markers have been proposed for risk stratification of subjects with BrS phenotype, but the majority have not yet been tested in a prospective manner in asymptomatic individuals. Recent data suggest that current risk factors are insufficient and cannot accurately predict sudden cardiac death events in this setting. This systematic review aims to discuss contemporary data regarding prognosis, risk stratification, and management of asymptomatic individuals with diagnosis of Brugada electrocardiogram pattern and to delineate the therapeutic approach in such cases.
Letsas et al. (Tue,) conducted a systematic review in Brugada syndrome. Risk stratification and management was evaluated on Sudden cardiac death. Current clinical, electrocardiographic, and electrophysiological risk factors are insufficient to accurately predict sudden cardiac death in asymptomatic individuals with Brugada syndrome.
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